What is mitral valve disease?

Mitral valve disease refers to irregular conditions of the
mitral valve. This valve is located between the two left chambers of your heart.
It works to keep blood flowing properly in one direction from the left atrium
to the left ventricle and prevents it from flowing backward.

When your mitral valve does not work properly, you can
experience symptoms such as fatigue and shortness of breath because the
defective valve is allowing blood to flow backward into the left atrium. Many
people with mitral valve disease experience no symptoms.

When the mitral valve does not function as it should, your
heart does not pump enough blood out of the left ventricular chamber to supply
your body with oxygen-filled blood. Mitral valve disease can be serious. Left
untreated, severe cases can lead to heart failure or irregular heartbeats,
called arrhythmias, which may be life-threatening.

Types
of mitral valve disease

There are three types of mitral valve disease: stenosis,
prolapse, and regurgitation.

Mitral valve stenosis

The valve opening becomes narrow. This means that not enough
blood can pass through into your left ventricle.

Mitral valve prolapse

The flaps on the valve bulge instead of closing tightly.
This might prevent the valve from closing completely, and regurgitation — the backward
flow of blood — may occur.

Mitral valve regurgitation

Blood leaks from the valve and flows backward into your left
atrium when the left ventricle compresses.

What
causes mitral valve disease?

Each form of mitral valve disease has its own set of causes.

Mitral valve stenosis

Mitral valve stenosis is typically caused by scarring from rheumatic fever.
Usually a childhood disease, rheumatic fever results from the body’s immune
response to a streptococcal bacterial infection. Rheumatic fever is a serious
complication of strep throat or scarlet fever.

The organs most affected by acute rheumatic fever are the
joints and the heart. The joints can become inflamed, which can lead to
temporary and sometimes chronic disability. Various parts of the heart can
become inflamed and lead to these potentially serious heart conditions:

If the mitral valve becomes inflamed or otherwise injured by
these conditions, it can lead to the chronic heart condition called rheumatic
heart disease. The clinical signs and symptoms of this condition might not
occur until 5 to 10 years after the episode of rheumatic fever.

Mitral stenosis is uncommon in the United States and other
developed countries where rheumatic fever is rare. This is because people in
developed countries generally have access to antibiotics that treat bacterial
infections such as strep
throat, according to the Merck
Manual Home Health Handbook. Most cases of mitral stenosis in the United
States are in older adults who had rheumatic fever before the widespread use of
antibiotics or in people who have moved from countries where rheumatic fever is
common.

There are other causes of mitral valve stenosis, but these
are rare. They include:

blood clots

calcium buildup

congenital heart defects

radiation treatment

tumors

Mitral valve prolapse

Mitral valve prolapse often has no specific or known cause.
It tends to run in families or occur in those who have other conditions, such
as scoliosis and
connective tissue problems, which can contribute to mitral valve prolapse.
According to the American Heart Association, about 2
percent of the U.S. population has a mitral valve prolapse. Even fewer
people experience serious problems associated with the condition.

Mitral valve regurgitation

A variety of heart problems can cause mitral valve
regurgitation. You may develop mitral valve regurgitation if you’ve had:

endocarditis, or inflammation of the heart’s lining and
valves

heart attack

rheumatic fever

Damage to your heart’s tissue cords or wear and tear to your
mitral valve can also lead to regurgitation. Mitral valve prolapse can
sometimes cause regurgitation.

What
are the symptoms of mitral valve disease?

Mitral valve disease symptoms vary depending on the exact
problem with your valve. A problem with your mitral valve may cause no symptoms
at all. When symptoms do occur, they can include:

cough

shortness of breath, especially when you are lying down
on your back or exercising

fatigue and tiredness

lightheadedness

You may also feel pain or tightness in your chest. In some
cases, you might feel your heart beating irregularly or quickly.

Symptoms of any type of mitral valve disease usually develop
gradually. Symptoms might appear or get worse when your body is dealing with
some sort of extra stress, such as infection or pregnancy.

How is mitral valve disease diagnosed?

If your doctor suspects that you may have a mitral valve disease,
they will listen to your heart with a stethoscope. Unusual sounds or rhythm
patterns can help them diagnose what’s going on.

Other tests that may help confirm a mitral valve disease
diagnosis include:

Imaging tests

echocardiogram: This test uses
ultrasound waves to produce images of the heart’s structure and function.

X-ray: This common test produces images on computer
or film by sending x-ray particles through the body.

transesophageal echocardiogram: This test produces a
more detailed image of your heart than a traditional echocardiogram. Your
doctor threads a device emitting ultrasound waves into your esophagus,
which is located right behind the heart. This test produces a more
detailed picture than a traditional echocardiogram.

cardiac catheterization: This procedure allows
your doctor to do a variety of tests, including getting an image of the
heart’s blood vessels. In the procedure, your doctor inserts a long, thin
tube into your arm, upper thigh, or neck and threads it up to your heart.

Tests to monitor heart activity

Holter monitoring: a procedure in which a portable
monitoring device records your heart’s electrical activity over a period
of time, usually 24–48 hours

Stress tests

Your doctor may want to monitor you while you exercise to
determine how your heart responds to physical stress.

How
is mitral valve disease treated?

Treatment for mitral valve disease may not be necessary,
depending on the severity of your condition and symptoms. If your case is
severe enough, there are three possible treatments or combination of treatments
that may correct your condition.

Drugs and medication

If treatment is necessary, your doctor may begin by treating
you with medications. There are no medications that can actually fix the
structural issues with your mitral valve. Some medications can ease your
symptoms or prevent them from getting worse. These medications may include:

Valvuloplasty

In some cases, your doctor may need to perform medical procedures.
For example, in cases of mitral valve stenosis, your doctor may be able to use
a balloon to open up the valve in a procedure called balloon valvuloplasty.

Surgery

Surgery may become necessary. Your doctor might be able to
surgically repair your existing mitral valve to make it function properly. If
that isn’t possible, you may need to have your mitral valve replaced with a new
one. The replacement might be either biological or mechanical. The biological
replacement might be obtained from a cow, pig, or human cadaver.

The takeaway

When the mitral valve does not function as it should, your
blood does not flow properly out of the heart. You may experience symptoms such
as fatigue or shortness of breath, or you may not experience symptoms at all.
Your doctor will use a variety of tests to diagnose your condition. Treatment
usually involves a variety of medications, medical procedures, or surgery.